US20180207032A1

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Publication number: US20180207032A1
Application number: US15/866,828
Authority: US
Inventors: Steven T. Charles; Brian William McDonell
Original assignee: Novartis AG
Current assignee: Alcon Inc
Priority date: 2017-01-26
Filing date: 2018-01-10
Publication date: 2018-07-26
Also published as: WO2018138592A1

Abstract

Vitrectomy probes and methods related thereto are disclosed herein. A vitrectomy probe may include a hand piece comprising a housing, a venturi, a piloted proportional valve disposed in the housing, and aspiration tubing fluidly coupled to the piloted proportional valve. In some embodiments, the piloted proportional valve and/or venturi may be disposed in the surgical console. The vitrectomy probe may further include a cutting mechanism attached to a distal end of the hand piece, wherein the cutting mechanism may be fluidly coupled to the aspiration tubing.

Description

BACKGROUNDPRIORITY CLAIM

This application claims the benefit of priority of U.S. Provisional Patent Application Ser. No. 62/450,672 titled “VACUUM CONTROL FOR A VITRECTOMY PROBE”, filed on Jan. 26, 2017, whose inventors are Steven T. Charles and Brian William McDonell, which is hereby incorporated by reference in its entirety as though fully and completely set forth herein.

Microsurgical procedures may frequently require precision cutting and/or removing various body tissues. For example, certain ophthalmic surgical procedures may require cutting and removing portions of the vitreous humor, a transparent jelly-like material that fills the posterior segment of the eye. The vitreous humor, or vitreous, is composed of numerous microscopic fibrils that are often attached to the retina. Therefore, cutting and removing the vitreous must be done with great care to avoid traction on the retina, the separation of the retina from the choroid, a retinal tear, or, in the worst case, cutting and removal of the retina itself. In particular, delicate operations such as mobile tissue management (e.g., cutting and removal of vitreous near a detached portion of the retina or a retinal tear), vitreous base dissection, and cutting and removal of membranes may be particularly difficult.

Vitrectomy probes may typically be inserted via an incision in the sclera in the pars plana. The surgeon may also insert other microsurgical instruments, such as a fiber optic endoilluminator, an infusion cannula, or an aspiration cannula during the posterior segment surgery. While performing the surgery, the surgeon may view the eye using a microscope. Vitrectomy probes may typically include an inner cutter needle and outer needle arranged coaxially with and movably disposed within the needle, and a port extending radially through the outer needle near the distal end thereof. Vitreous and/or membranes may be aspirated into the open port, and the cutter may be actuated, closing the port. Upon the closing of the port, cutting surfaces on both the inner cutter needle and outer needle may cooperate to cut the vitreous and/or membranes, and the cut tissue may then be aspirated away through the cutter. Additional vitrectomy probes may include laser cutters and ultrasonic cutters, among others. Tubing connecting a cutter with a console/cassette/vacuum valve(s) may cause a delay (e.g., speed of sound in fluid) and capacitance effects. The tubing may contract when a vacuum is applied, and may expand causing a residual vacuum when console/cassette vacuum commands decrease. The console/cassette vacuum commands may be controlled by a surgeon foot pedal.

SUMMARY

In an exemplary aspect, the present disclosure is directed to a vitrectomy probe including a hand piece, a housing, a piloted proportional valve disposed in the housing, and aspiration tubing fluidly coupled to the piloted proportional valve. The vitrectomy probe may include a cutting mechanism attached to a distal end of the hand piece, and the cutting mechanism may be fluidly coupled to the aspiration tubing.

In another exemplary aspect, the present disclosure is directed to a vitrectomy probe including a hand piece that includes a housing, a venturi disposed in the housing, and aspiration tubing fluidly coupled to the venturi. The vitrectomy probe may include a supply line fluidly coupled to the venturi and a surgical console. The vitrectomy probe may include a cutting mechanism attached to a distal end of the hand piece, and the cutting mechanism may be fluidly coupled to the aspiration tubing.

In another exemplary aspect, the present disclosure is directed to a system that includes a vitrectomy probe. The vitrectomy probe may include a hand piece that includes a housing, a piloted proportional valve that may be disposed in the housing, and aspiration tubing that may be fluidly coupled to the piloted proportional valve. The vitrectomy probe may include a cutting mechanism attached to a distal end of the hand piece, and the cutting mechanism may be fluidly coupled to the aspiration tubing. The system may include a surgical console coupled to the vitrectomy probe.

In another exemplary aspect, the present disclosure is directed to a method for operating a vitrectomy probe. The method may include positioning a cutting mechanism extending from the vitrectomy probe in an eye, and the vitrectomy probe may include a hand piece that includes a housing, a piloted proportional valve that may be disposed in the housing, and aspiration tubing that may be fluidly coupled to the piloted proportional valve. The vitrectomy probe may include a cutting mechanism attached to a distal end of the hand piece, and the cutting mechanism may be fluidly coupled to the aspiration tubing. The method may further include cutting tissue within the eye with the cutting mechanism and aspirating material from the eye through the cutting mechanism and the hand piece.

The different aspects may include one or more of the following features. The vitrectomy probe may include a piloted proportional valve disposed in the hand piece, and the piloted proportional valve may be fluidly coupled to the venturi and the surgical console.

The different aspects may include one or more of the following features. The material may pass through the piloted proportional valve to a surgical console. The surgical console may include a vacuum source that may provide vacuum pressure to the aspiration tubing. The hand piece may further include a venturi, and the material may pass through the aspiration tubing and the venturi.

It is to be understood that both the foregoing general description and the following drawings and detailed description are exemplary and explanatory in nature and are intended to provide an understanding of the present disclosure without limiting the scope of the present disclosure. It is also to be understood that the components described herein may be arranged in a different order or arranged in different locations in the system. For example, the piloted proportional valve and/or venturi may be located in the surgical console instead of the hand piece. Additional aspects, features, and advantages of the present disclosure will be apparent to one skilled in the art from the following.

BRIEF DESCRIPTION OF THE DRAWINGS

For a more complete understanding of the present disclosure, reference is made to the following description taken in conjunction with the accompanying drawings in which:

FIG. 1 illustrates an example vitrectomy probe with a piloted proportional valve.

FIG. 2A illustrates an example vitrectomy probe with a piloted proportional valve and a venturi.

FIG. 2B illustrates an example vitrectomy probe with a venturi, and the vitrectomy probe is connected to a console containing the piloted proportional valve.

FIGS. 3A-3D illustrate an example cutting cycle for a vitrectomy probe.

FIG. 4 illustrates an example of a cutting mechanism being inserted into a posterior segment of an eye.

FIG. 5 illustrates a flowchart of a method for operating a vitrectomy probe.

DETAILED DESCRIPTION

For the purposes of promoting an understanding of the principles of the present disclosure, reference will now be made to the implementations illustrated in the drawings and specific language will be used to describe them. It will nevertheless be understood that no limitation of the scope of the disclosure is intended. Any alterations and further modifications to the described devices, instruments, methods, and any further application of the principles of the present disclosure are fully contemplated as would normally occur to one skilled in the art to which the disclosure relates. In particular, it is fully contemplated that the features, components, and/or steps described with reference to one or more implementations may be combined with the features, components, and/or steps described with reference to other implementations of the present disclosure. For simplicity, in some instances the same reference numbers are used throughout the drawings to refer to the same or like parts.

The present disclosure generally relates to a vitrectomy probe and associated methods of use. More particularly, embodiments may generally relate to vitrectomy probes that may include a venturi and/or a piloted proportional valve in the hand piece. In some embodiments, the piloted proportional valve and/or venturi may be located in the surgical console instead of the hand piece. A separate pneumatic pressure source line may drive the venturi. By inclusion of the venturi and/or piloted proportional valve in the hand piece, response time may be decreased. For example, a surgeon's response time may be no less than400 milliseconds (“ms”), wherein it may be desired for the aspiration fluidic system to cause minimal additional delay. With a reduction in response time, safety may be improved. For example, there may be a decrease in the likelihood/number of retinal tears created by pulling on the vitreous and therefore procedures on the retina and/or movement of a detached retina toward a port of a cutting mechanism, may be improved.

FIG. 1 illustrates an example of avitrectomy probe10.Vitrectomy probe10 may comprisehand piece12 and acutting mechanism14.Vitrectomy probe10 may be coupled (e.g., fluidly and/or electrically) tosurgical console17.

In some embodiments, thecutting mechanism14 may comprise aninner needle15 and anouter needle16. In the illustrated embodiment, theinner needle15 may be coaxially arranged in theouter needle16. In some embodiments, theinner needle15 and theouter needle16 may both be tubular in shape with a hollow bore. In the illustrated embodiment, thecutting mechanism14 may be attached to thehand piece12 at itsdistal end34. Thecutting mechanism14 may comprise any suitable cutter, such as, for example, a rotary mechanical cutter, an axial mechanical cutter (e.g., a pneumatically driven axial cutter), an ultrasonic cutter or a laser cutter.

With continued reference toFIG. 1, power may be supplied to thevitrectomy probe10 via a power cable. The power cable may be coupled to thesurgical console17, and thesurgical console17 may be operable to adjust the power applied to thevitrectomy probe10 based, for example, on an input to thesurgical console17 by a user, such as, for example, a surgeon. Input from a user to thesurgical console17 may be provided via an input device, such as, for example, a touch screen, button, slider, footswitch, and/or other input device. In some embodiments, thesurgical console17 may be coupled (e.g., fluidly coupled or electrically coupled) to the pilotedproportional valve22 via a line32 (e.g., wire or tube). As illustrated, avacuum source36 may be disposed insurgical console17. In some embodiments, the pilotedproportional valve22 may be fluidly coupled to thevacuum source36 via thetube30. In some embodiments,surgical console17 may also includecassette28 for receiving and storing aspirated material from thecutting mechanism14 by way of thehand piece12. Thecassette28 may be fluidly coupled to vacuum source36 (e.g., aspiration pathway33). Thecassette28 may be changed for each patient and may cooperate withsurgical console17 to provide fluid aspiration.Cassette28 may be used for positive displacement aspiration, vacuum-based aspiration, or both. Thecassette28 may include anaspiration pathway38 coupled to thevacuum source36 and may allowsurgical console17 to selectively drive aspiration withvacuum source36.

An example embodiment for operation of thevitrectomy probe10 ofFIG. 1 for aspiration of ophthalmic tissue during an ophthalmic surgical procedure will now be described. Thecutting mechanism14 may be operated to remove the ophthalmic tissue (e.g., vitreous humor76 (interchangeably referred to as “vitreous”) onFIG. 4). Dissected tissue and/or fluid may be drawn into thecutting mechanism14 and flow into theaspiration tubing20 in thehand piece12. The aspirated material may be received in pilotedproportional valve22 by way of theinlet24. The aspirated material may be discharged from the pilotedproportional valve22 by way of theoutlet26. Aspirated material discharged from the pilotedproportional valve22 may be received by thecassette28 in thesurgical console17 by way oftube30. Vacuumsource36 may supply a vacuum pressure to thecutting mechanism14. The pilotedproportional valve22 may control vacuum pressure as theinlet24 and theoutlet26 open or close, thereby controlling the aspiration of material through thehand piece12.

FIG. 2A illustrates another embodiment of thevitrectomy probe10 that may further comprise a venturi40 (e.g., a venturi tube). Thevitrectomy probe10 may comprise ahand piece12 and acutting mechanism14. Thehand piece12 may comprise theventuri40. Thevitrectomy probe10 may be coupled (e.g., fluidly and/or electrically) to asurgical console17. While illustrated with a pilotedproportional valve22 in thehand piece12, theventuri40 may alternatively be controlled with a supply fluid sent directly from thesurgical console17.

Thehand piece12 may comprise ahousing18 containing anaspiration tubing20, theventuri40, and a pilotedproportional valve22, each being disposed, for example, in thehousing18. Theaspiration tubing20 may be fluidly coupled to thecutting mechanism14 for aspirating material, such as fluid and tissue, from thecutting mechanism14. Theaspiration tubing20 may also be fluidly coupled to theventuri40, which may include anentry cone44 and anexit cone46. Theentry cone44 may be fluidly coupled to pilotedproportional valve22 viasupply tube56. A supply fluid may be delivered to theventuri40 through thesupply tube56. Theexit cone46 may be fluidly coupled totube52. A mixture of the supply fluid and aspirated material may be discharged from theventuri40 through theexit cone46. Theventuri40 may further comprise aninlet48 between theentry cone44 andexit cone46. Theaspiration tubing20 may be fluidly coupled to theinlet48 for delivery of the aspirated material to theventuri40. Theventuri40 may comprise aflow restriction50 between theentry cone44 and theexit cone46. By way of example, theventuri40 may have an hourglass shape that forms theflow restriction50. Theflow restriction50 may be configured to vary flow characteristics of the supply fluid (e.g., liquid and/or gas) traveling through theventuri40. As the supply fluid velocity in theventuri40 is increased (e.g., via flow restriction50), there may be a consequential drop in pressure, which may be referred to as the “Venturi Principle” or “Venturi Effect”. Theventuri40 may use this pressure drop (e.g., a pressure drop may cause a suction or vacuum) to draw aspirated material from thecutting mechanism14 and into theinlet48.

In some embodiments, the pilotedproportional valve22 may be operable to control flow of the supply fluid to theventuri40. The pilotedproportional valve22 may includeinlet24 andoutlet26 which may open or close based on an electrical signal or pressure signal (e.g., analog pressure due to a fluid) sent from thesurgical console17 via theline54, thereby controlling a flow of the supply fluid insupply tube56 to theentry cone44. Theinlet24 may be coupled to supplytube56 for receiving a supply fluid (e.g., saline or sterile water), for example, from thesurgical console17. Theoutlet26 may discharge the supply fluid from the pilotedproportional valve22.Supply tube56 may couple the pilotedproportional valve22 to theventuri40 to provide the supply fluid to theventuri40 via theentry cone44.

With continued reference toFIG. 2A, power may be supplied to thevitrectomy probe10 via a power cable. The power cable may be coupled to thesurgical console17, and thesurgical console17 may be operable to adjust the power applied to thevitrectomy probe10 based, for example, on an input to the surgical console by a user, such as, for example, a surgeon. Input from a user to thesurgical console17 may be provided via an input device, such as, for example, a surgeon controlled proportional foot pedal. Thesurgical console17 may be coupled (e.g., fluidly coupled or electrically coupled) to the pilotedproportional valve22 via a line54 (e.g., wire or tube). Theexit cone46 may be fluidly coupled to avacuum source36 via a tube52 (e.g., exhaust tube). Thevacuum source36 may be disposed in thesurgical console17.Surgical console17 may also includecassette28 for receiving and storing aspirated fluid and/or tissue. Thecassette28 may be fluidly coupled to vacuum source36 (e.g., aspiration pathway38). Thecassette28 may be changed for each patient and may cooperate withsurgical console17 to provide fluid aspiration.Cassette28 may be used for positive displacement aspiration, vacuum-based aspiration, or both. Thecassette28 may include anaspiration pathway38 coupled to thevacuum source36 and may allowsurgical console17 to selectively drive aspiration withvacuum source36.

An example embodiment for operation of thevitrectomy probe10 ofFIG. 2A for aspiration of ophthalmic tissue during an ophthalmic surgical procedure will now be described. Thecutting mechanism14 may be operated to remove the ophthalmic tissue (e.g., vitreous humor76 (interchangeably referred to as “vitreous”) onFIG. 4). Dissected tissue and/or fluid may be drawn into thecutting mechanism14 and flow into theaspiration tubing20 in thehand piece12. The aspirated material may be received in theventuri40 by way of theinlet48. In addition, the pilotedproportional valve22 may be operated to control an amount of the supply fluid to theentry cone44. The supply fluid travels through theventuri40 exiting by way of theexit cone46. As the supply fluid velocity in theventuri40 is increased (e.g., via flow restriction50), there may be a consequential drop in pressure. Theventuri40 may use this pressure drop (e.g., a pressure drop may cause a suction or vacuum) to draw the aspirated material from the cutting mechanism and into theventuri40 by way of theinlet48. The aspirated material may mix with the supply fluid in theventuri40 and be discharged from theventuri40 by way of theexit cone46. Aspirated material discharged from theventuri40 may be received by thecassette28 in thesurgical console17 by way of thetube52. In some embodiments, thevacuum source36 may supply a vacuum pressure to thecutting mechanism14.

FIG. 2B illustrates a similar embodiment asFIG. 2A except the pilotedproportional valve22 is located in thesurgical console17 and theventuri drive line42 extends from the pilotedproportional valve22 in theconsole17 to theventuri40 in the handpiece (e.g., through a flexible tube). As shown inFIG. 2B, thesupply tube56 and the signal line54 (receiving the electrical signal or pressure signal) may both be internal to theconsole17 and connected to the pilotedproportional valve22. In some embodiments, the venturi valve may also be located in the control console (in which case,aspiration tubing20 may extend from the hand piece to the console). Other configurations are also contemplated.

FIGS. 3A-3D illustrates a detailed view of an example of thecutting mechanism14 in accordance with example embodiments of the present disclosure. Although an axial mechanical cutter is illustrated inFIGS. 3A-3D, other suitable cutters, such as, for example, a rotary mechanical cutter, oscillating rotary cutter, an ultrasonic cutter or a laser cutter may be used. In some embodiments, theinner needle15 may be in the form of a hollow cylinder, but other configurations of thecutter14 may also be suitable. As illustrated, aport58 may be formed in theinner needle15 that may receive various materials, such as tissue or fluid, during operation. In some embodiments, the tissue may be ophthalmic tissue, such as vitreous and/or membrane. Theport58 may be of a polygonal (e.g., rectangular) or other suitable shape. Theinner needle15 may be in the form of a single blade configuration or a dual blade or dual port configuration including two cutting edges, for example,proximal cutting edge60 anddistal cutting edge62. Theproximal cutting edge60 may be formed at a distal side of theport58. Thedistal cutting edge62 may be formed at a distal side of theinner needle15. When moving, theproximal cutting edge60 and thedistal cutting edge62 may cut material, such as tissue. For example, theproximal cutting edge60 anddistal cutting edge62 may cooperate with cutting edges on theouter needle16 to cut the material. Theinner needle15 may be made of any suitable material, including surgical stainless steel. Theinner needle15 may be of any suitable dimensions, including, but not limited to, a length of about 1 inch to about 2 inches. Additionally, in some embodiments, theinner needle15 may have a size that ranges from about 23 gauge to about 27 gauge. One of ordinary skill in the art, with the benefit of this disclosure, should be able to select the dimensions and operating parameters for use of theinner needle15 in a particular application.

Referring now toFIG. 4, use of cuttingmechanism14 in an ophthalmic surgical procedure will now be described in accordance with an example embodiment. As illustrated inFIG. 4, during an ophthalmic surgical procedure, such as a retinal surgical procedure, theinner needle15 and theouter needle16 may be inserted into theposterior segment66 of theeye68. For example, theinner needle15 and theouter needle16 may be inserted through acannula70 disposed in anincision72. Theincision72 may be made through thesclera74 of theeye68. Once positioned, thecutting mechanism14 may be operable to remove and aspirate ophthalmic tissue, such as vitreous and/or membrane. For example, during a retinal surgical procedure, theouter needle16 withinner needle15 disposed therein, may be inserted into theposterior segment66 of theeye68. Thecutting mechanism14 may be operated to remove the ophthalmic tissue, which may include vitreous humor76 (interchangeably referred to as “vitreous”), a jelly-like substance that occupies the volume defined by theposterior segment66, as theinner needle15 moves back and forth withinouter needle16. Theinner needle15 may also be used to remove membranes covering the retina or other tissues. Dissected tissue and/or fluid from theeye68 may be removed via theouter needle16, as mentioned above (e.g., shown inFIGS. 3A-3D). Although an axial mechanical cutter is illustrated inFIG. 4, other suitable cutters, such as, for example, a rotary mechanical cutter, an ultrasonic cutter or a laser cutter may be used.

FIG. 5 illustrates a flowchart of a method for operating a vitrectomy probe. The elements provided in the flowchart are illustrative only. Various provided elements may be omitted, additional elements may be added, and/or various elements may be performed in a different order than provided below.

At501, a cutting mechanism extending from the vitrectomy probe may be positioned in an eye. The vitrectomy probe may include a hand piece comprising a housing, a piloted proportional valve disposed in the housing, and aspiration tubing fluidly coupled to the piloted proportional valve. The cutting mechanism may be attached to a distal end of the hand piece, and the cutting mechanism may be fluidly coupled to the aspiration tubing.

At503, tissue within the eye may be cut with the cutting mechanism.

At505, material from the eye may be aspirated through the cutting mechanism and the hand piece. In some embodiments, the material may pass through the piloted proportional valve to a surgical console that has a vacuum source providing vacuum pressure to the aspiration tubing. In some embodiments, the hand piece may further include a venturi and the material may pass through the aspiration tubing and the venturi.

At507, a supply fluid may be supplied from the piloted proportional valve to the venturi.

It is believed that the operation and construction of the present disclosure will be apparent from the foregoing description. While the apparatus and methods shown or described above have been characterized as being preferred, various changes and modifications may be made therein without departing from the spirit and scope of the disclosure as defined in the following claims.

Claims

What is claimed is:

1. A vitrectomy probe comprising:

a hand piece comprising a housing, a piloted proportional valve disposed in the housing, and aspiration tubing fluidly coupled to the piloted proportional valve; and

a cutting mechanism attached to a distal end of the hand piece, wherein the cutting mechanism is fluidly coupled to the aspiration tubing.

2. The vitrectomy probe ofclaim 1, wherein the piloted proportional valve is controlled by an electrical signal or a pressure signal.

3. The vitrectomy probe ofclaim 1, wherein the piloted proportional valve comprises an inlet coupled to the aspiration tubing for receiving aspirated material from the cutting mechanism and an outlet for discharging the aspirated material, the outlet being coupled to a vacuum source.

4. The vitrectomy probe ofclaim 1, wherein the piloted proportional valve is operable to control flow of aspirated material from the cutting mechanism through the hand piece.

5. The vitrectomy probe ofclaim 1, wherein the cutting mechanism is an axial mechanical cutter, a rotary mechanical cutter, an ultrasonic cutter, or a laser cutter.

6. The vitrectomy probe ofclaim 1, wherein the hand piece further comprises a venturi fluidly coupled to the piloted proportional valve and fluidly coupled to the aspiration tubing.

7. The vitrectomy probe ofclaim 6, wherein the venturi comprises an entry cone, an exit cone, and a flow constriction disposed between the entry cone and the exit cone, the venturi being configured to create a pressure drop to draw aspirated material from an eye through the aspiration tubing.

8. The vitrectomy probe ofclaim 7, wherein the venturi comprises an inlet between the entry cone and the exit cone, the inlet being coupled to the aspiration tubing for receiving aspirated material from the cutting mechanism.

9. The vitrectomy probe ofclaim 8, wherein the entry cone is coupled to the piloted proportional valve for receiving a supply fluid from the piloted proportional valve, wherein the exit cone discharges a mixture of the supply fluid and the aspirated material from the venturi.

10. The vitrectomy probe ofclaim 7, wherein a supply line is fluidly coupled to an inlet of the piloted proportional valve for receiving a supply fluid, the piloted proportional valve comprising an exit for discharging the supply fluid to the venturi, wherein the piloted proportional valve is operable to control flow of the supply fluid to the venturi.

11. A vitrectomy probe comprising:

a hand piece comprising a housing, a venturi disposed in the housing, and aspiration tubing fluidly coupled to the venturi;

a venturi drive line coupled to the venturi on one end and to a piloted proportional valve disposed in a surgical console on the other end; and

12. The vitrectomy probe ofclaim 11, further comprising an exhaust tube coupled between the surgical console and an output of the venturi.

13. A system comprising:

a vitrectomy probe comprising:

a hand piece comprising a housing, a venturi disposed in the housing, and aspiration tubing fluidly coupled to the venturi; and

a cutting mechanism attached to a distal end of the hand piece, wherein the cutting mechanism is fluidly coupled to the aspiration tubing; and

a surgical console coupled to the vitrectomy probe.

14. The system ofclaim 13, further comprising a piloted proportional valve coupled to the venturi, wherein the piloted proportional valve is disposed in the handpiece or the surgical console.

15. The system ofclaim 13, wherein the venturi comprises an inlet coupled to the aspiration tubing for receiving aspirated material from the cutting mechanism and an outlet for discharging the aspirated material, the surgical console comprising a vacuum source coupled to the outlet.

16. The system ofclaim 13, wherein the venturi is operable to control flow of aspirated material from the cutting mechanism through the hand piece, wherein the system further comprises a venturi drive line between the piloted proportional valve and the venturi.

17. The system ofclaim 14, wherein the venturi comprises an entry cone, an exit cone, and a flow constriction disposed between the entry cone and the exit cone, the venturi being configured to create a pressure drop to draw aspirated material from an eye through the aspiration tubing.

18. The system ofclaim 17, wherein the venturi comprises an inlet between the entry cone and the exit cone, the inlet being coupled to the aspiration tubing for receiving aspirated material from the cutting mechanism, wherein the entry cone is coupled to the piloted proportional valve for receiving a supply fluid from the piloted proportional valve, wherein the exit cone discharges a mixture of the supply fluid and the aspirated material from the venturi to the surgical console.

19. The system ofclaim 17, wherein a supply line is fluidly coupled to an inlet of the piloted proportional valve for receiving a supply fluid, the piloted proportional valve comprising an exit for discharging the supply fluid to the venturi, wherein the piloted proportional valve is operable to control flow of the supply fluid to the venturi.

20. The system ofclaim 13, wherein the surgical console comprises a vacuum source, wherein a tubing couples the vacuum source to the hand piece.